Individual
MR. REX ALLEN MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-6781
(208) 356-3111
Mailing address
37 S 2ND E, REXBURG, ID 83440-1906
(208) 356-0234
(208) 656-8444
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-923
ID
Other
Enumeration date
08/31/2011
Last updated
06/01/2021
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